Delayed-Type Heparin Allergy: Diagnostic Procedures and Treatment Alternatives-A Case Series Including 15 Patients

Autor: Claudia Pföhler, Cornelia SL Müller, Gerhard Pindur, Hermann Eichler, Hans-Joachim Schäfers, Ulrich Grundmann, Wolfgang Tilgen
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Zdroj: World Allergy Organization Journal, Vol 1, Iss 12, Pp 194-199 (2008)
Druh dokumentu: article
ISSN: 1939-4551
DOI: 10.1097/WOX.0b013e31818def58
Popis: Delayed-type hypersensitivity reactions (DTHRs) after subcutaneous application of unfractionated heparins or low-molecular-weight heparins are not uncommon. Standard allergological testing usually includes intracutaneous skin tests and patch testing of different heparins, heparinoids, and thrombin inhibitors followed by subcutaneous and/or intravenous challenge with skin test-negative drugs. We present data from a single-center case series of 15 patients with DTHR after low-molecular-weight heparin administration. Intracutaneous testing that can be considered as gold standard identified the suspicious elicitor in 11 (73.4%) of 15 of the patients. Patch testing was positive in 5 (33.4%) of 15 of the patients and was only positive in patients who were also reacting in the intradermal testing. Intravenous challenge with heparin sodium was performed in 10 of 15 patients and was well tolerated in all cases, despite prior positive intracutaneous tests with the same substance. Intracutaneous documentation of DTHR was not an adequate predictor of intravenous challenge. Keywords: heparin, allergy, alternatives, pregnancy, cardiac surgery, thrombosis
Databáze: Directory of Open Access Journals